Results of Chordoma Patients Treated by Different Approaches in a Single Institution

Muge AKMANSU1,Gokhan KURT2,Volkan DEMIRCAN1,Ertugrul SENTURK1

1Gazi University, School of Medicine, Department of Radiation Oncology, Ankara, Turkey2Gazi University, School of Medicine, Department of Neurosurgery, Ankara, Turkey
DOI :
10.5137/1019-5149.JTN.24406-19.4
AIM: To discuss the optimal and recent treatment options based on clinical review of 16 chordoma patients.

MATERIAL and METHODS: Data of the patients diagnosed and treated between 1999 and 2017 in Gazi University School of
Medicine has been collected through patientsâ files and the electronic database of hospital records. Statistical analysis was applied
to evaluate the correlation between the progression free survival and treatment modalities.

RESULTS: Nine of the 16 patients were women (56.3%). Half of the patients had intracranially located tumors, whereas the other
50% of the sample had spinal (n=5) and sacral (n=3) chordomas. The median follow-up time was 51.7 months. Recurrence was
observed in 50% of patients, while the median recurrence time equaled to 27.6 months. Multivariate analysis results showed that
age, gender tumor size, intra or extracranial location of tumor, treatment modalities, subtotal or grosstotal resection of tumor,
radiotherapy dose, and techniques were not associated with recurrence. On the other hand, 2 patients are still under chemoterapy
(imatinib, bevacizumab) without evident of recurrent disease.

CONCLUSION: Despite the fact that surgery remains to be the cornerstone of treatment, total resection is not reasonable for all
patients with chordomas. For this reason, adjuvant treatment for ensuring local control is highly important. If the residual tumor
is of a small volume, SBRT may provide more advantages. Targeted treatment or chemotheapeutic agents may also be benificial
for maintanence therapy. As the clinical awareness about chordomas is based on our series, aggressive multi-modality treatment
options should be applied in the adjuvant therapy.